• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.2
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• pp.122-131
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• 2019

The majority of children with cerebral palsy (CP) have feeding difficulties and are especially prone to malnutrition. The early involvement of a multidisciplinary team should aim to prevent malnutrition and provide adequate nutritional support. Thorough nutritional assessment, including body composition, should be a prerequisite for the nutritional intervention. As in typically-developed children nutritional support should start with dietary advice and the modification of oral feeding, if safe and acceptable. However, for prolonged feeding, in the presence of unsafe swallowing and inadequate oral intake, enteral nutrition should be promptly initiated and early gastrostomy placement should be evaluated and discussed with parents/caregivers. Gastrointestinal problems (oropharyngeal dysfunction, gastroesophageal disease, and constipation) in children with CP are frequent and should be actively detected and adequately treated as they can further worsen the feeding process and nutritional status.

• Physical Therapy Korea
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• v.13 no.1
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• pp.54-60
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• 2006

This study aimed to compare movement patterns of shoulder joints between the right and left symmetry in stroke patients and control subjects. This study proposes use of the voluntary response index (VRI) calculated from quantitative analysis of surface electromyographic (sEMG) and motion data recorded during voluntary movement as a feeding task. The VRI is comprised of two numeric values, one derived from the total muscle activity recorded for the voluntary motor task (magnitude), and the other from the sEMG distribution across the recorded muscles with the similarity index (SI). Five stroke patients and five age-matched healthy controls were recruited. Feeding motion was performed using the provided spoon five times with rests taken on a chair in between tasks. EMG data were digitized and analyzed on the basis of the root mean square (RMS) envelope of activity. The average amplitude of responses was calculated. Responsiveness and clinically meaningful levels of discrimination between stroke patients and control for EMG magnitude and SI were determined. The similarity index of the results from two successive examinations of both sides apart for stroke patients and control subjects were .86 and .95 in motion analysis and .84 and .99 in electromyographic analysis. The SI of sEMG data and motion data was significantly correlated in stroke patients. The data suggest that SI is a sensitive program for comparing and analyzing the symmetry of muscle activity and motion in both sides. This analysis method has a clinical value in grading muscular activity and movement impairment after brain injury.

• The Journal of Korean Academy of Sensory Integration
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• v.8 no.1
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• pp.73-86
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• 2010

Problems in feeding habits could affect various aspects of children including growth, learning, communication, interaction with other children, etc. Oral consumption was defined as a participant opening his/her mouth, accepting food/liquid, and swallowing. A goal of the study is to find a method of evaluation and intervention of a child's feeding habits. Feeding is an important component in the early development of children and may have later consequences in the child's ability to participate successfully in their activities of daily life. Children show personal difference on the foods which they try first because stimuli from the foods are revealed as a mealtime behavior through sensory registration and processing. Feeding problems in sensory processing consist of tactile oversensitivity, oral refusal, tactile undersensitivity, and oral dyspraxia. In order to identify problems of sensory processing among feeding difficulties and plan intervention, the understanding of neurological processing and sensory processing characteristics related to feeding is necessary. Reviewing intervention for feeding problems related to sensory processing is required for an effective approach for feeding and providing better life for children.

• 재활복지
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• v.20 no.4
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• pp.283-299
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• 2016

The purpose of this study was to investigate the effect of dysphagia intervention function and life quality of stroke patients. each 5 patients were randomly assigned in two groups, control group performing indirect feeding and experimental group performing direct feeding. Evaluation of the swallowing function was performed before intervention, after 4weeks and 8 weeks using CDS, PAS with VFSS and quality of life was performed twice, before and after intervention. Two groups showed the improved swallowing function, control group showed the significant difference only in CDS(p<.05). but experimental group showed the significant differenc in CDS and PAS(p<.01). both groups showed the significant improvement in quality of life(p<.05). but in comparison between group, no significant statistical difference were found(p>.05). Therefore, this study showed that both the swallowing function and quality of life were improved as time passed, but swallowing function was much more improved in experimental group.

• Therapeutic Science for Rehabilitation
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• v.8 no.3
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• pp.31-41
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• 2019

Objective: This study was conducted to comprehensively analyze domestic and international literature on the oral sensorimotor intervention approaches and evaluation/non-instrumental assessment methods for children with cerebral palsy with feeding disorders. Methods: One hundred and seventy-six papers published from January 2009 to December 2018 were screened. Forty-seven papers were selected based on the abstract and title, and five papers were selected through a secondary search. Results: The PEDro scale of the selected papers was high with an average of 7 points, and the therapeutic intervention period was found to be between 2 and 6 months, providing therapeutic interventions once to 5 times a week, at least 15 minutes to 1 hour a day. The treatment approach was used with impairment-based intervention and adaptive-based intervention, and the assessment method was divided into clinical evaluation and non-instrumental assessments. Conclusion: Through this systematic review, we found that there are a variety of oral sensorimotor interventions for children with cerebral palsy with feeding disorders. This study provides support for planning oral sensorimotor intervention programs for occupational therapy in clinical practice for children with cerebral palsy.

• Journal of Chest Surgery
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• v.6 no.1
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• pp.89-94
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• 1973

Esophagel atresia and tracheoesophageal fistula may occur as separate entities but usually occur in combination. First described by Durston in 1670, esophageal atresia was not successfully treated until 1939 when Ladd in Boston and Leven in St. Paul obtained the first survivors utilizing the methods of gastrostomy, esophagostomy and extrapleural ligation of the tracheoesophageal fistula as multiple operations which required months of hospitalization. Two years later Cameron Haight performed the first successful primary repair and afterward about 2000 cases of esophageal atresia with distal tracheoesophageal fistula reported in the world. In Korea, there appeared about 27 cases in the literature and 8 successful repaired cases noted in these year. Anther report two cases of esophageal atresia, of which one case was successfully treated with Haight`s method. Case 1.: Normal full term delivered boy with chief complaints of respiratory difficulty and persistent drooling with chocking, 3. lkg, was admitted with emergency 5 hours after delivery. Physical findings revealed no specific abnormal signs except distended abdomen and grunting respiration. Esophagograrn and bronchogram revealed proximal esophageal atresia and distal tracheoesophageal fistula proximal to the carina. Parent refused operative therapy and patient died 24 hours after discharge. Case 2. :3. lkg. normal full term delivered girl was admitted 4 days after delivery with chief complaints of regurgitation after feeding, chocking, cyanotic spell and fever since the day after delivery. Physical examination revealed persistent drooling, grunting respiration, and fever with moderate dehydration. Tracheoesophageal suction and fluid therapy with antibiotics improved her condition and subsided ]pneumonic condition. Esophagogram revealed markedly dilated proximal esophagus as blind loop and stomach distended with gas, and repairing operation as Haight`s method was performed on the 7th day after delivery. Patient tolerated all the operative procedure well and recovered uneventfully. Esophagogram on the 7th postoperative day showed passage of the lipiodol through the anastomotic side with moderate stricture,and feeding permitted. Patient tolerated all the feeding amount well and discharged on the 11th postoperative day. Followup revealed intermittent regurgitation after feeding and corrected with bougination.

• Journal of The Korean Society of Clinical Toxicology
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• v.22 no.1
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• pp.1-9
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• 2024

Purpose: Nutritional therapy is a crucial component of therapy for critically ill patients, but there is a lack of nutritional support guidelines for organophosphate (OP) poisoning, likely due to the gastrointestinal effects of atropine, the main antidote for OP. This study investigated whether enteral nutrition (EN) during atropinization is acceptable for mechanically ventilated patients after OP poisoning. Methods: This retrospective study classified 82 patients with OP poisoning according to whether they were fed during atropinization while on mechanical ventilation (MV). Data on the baseline characteristics, nutritional support, and clinical outcomes were compared. Univariate and multivariate regression models were constructed to analyze the associations between atropine administration for OP poisoning and feeding intolerance-related EN after adjustment for risk factors. Results: Eighty-two patients received EN after 72 hours on MV, and 40 of them simultaneously received 2 mg/hr atropine for the first 120 hours after EN initiation. The overall incidence of feeding intolerance was 57.3% during the first 12 days after EN initiation and did not differ according to atropine administration. Appropriate atropinization during EN in regression model 1 and the dosage of atropine administered during EN and the duration of EN during atropinization in model 2 were not associated with feeding intolerance in patients on MV after OP poisoning. Conclusion: Appropriate atropinization is not associated with feeding intolerance after EN provision in patients on MV after OP poisoning. This study will help establish nutritional guidelines for OP poisoning patients. More research on nutritional support is needed to validate our results.

• Therapeutic Science for Rehabilitation
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• v.2 no.2
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• pp.47-59
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• 2013

Objective : This study is conducted to find the influence on upper extremity function, cognitive function and activities of daily living when stroke patients receive task-oriented training in group or individually. Methods : Twenty-six inpatients are assigned to two groups(task training group and individual training group) randomly, who receive rehabilitation therapy after stroke diagnosis for 5 months(june to november, 2012) in a hospital. Both groups receive a task-oriented training for 30 minutes a day for 3 weeks. FMA were used to measure upper extremity function, K-MMSE were used to measure cognition, and MBI for ADL. Results : Before training. two groups were not different significantly in upper extremity function and cognitive function. But in activities of daily living, bathing self(p<.001), feeding, personal hygiene and total score(p<.05) are higher in group training group. After training, upper extremity function is higher in individual training group(p<.001). In both training group, upper extremity function, feeding, personal hygiene, bathing self, dressing, toilet, chair/bed transfers, ambulation and stair climbing, total score are improved significantly(p<.05). In comparing of variation before and after training, upper extremity function(p<.001), feeding and total score of activities of daily living are more improved significantly in individual training group(p<.05). Conclusion : The outcome shows that task-oriented training can improve upper extremity function and activities of daily living in both training group. Especially, the more upper extremity function is improved, the more activities of daily living is improved. In the future, it will be necessary longitudinal study for a long time for more patients.

• The Journal of Pediatrics of Korean Medicine
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• v.29 no.1
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• pp.27-43
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• 2015

Objectives The purpose of this study was to investigate the effects of AI on AD induced by DNCB in mice. AI has antiallergic property that is useful in treating allergy-related-diseases, such as asthma, anaphylactic shock, acute bronchitis and skin diseases, skin pruritus from gastrointestinal diseases. However, AI has not been studied intensively yet regarding anti-inflammatory effect on AD. Therefore, this study was conducted on 2,4-dinitrochlorobezene (DNCB)-induced mice to investigate effects of AI in AD. Methods In the experiment, we divided mice into four groups: a normal group (NOR), a control group (CON), an AI spread group (AI spread), and an AI spread and feeding group (AI spread & feeding). Then examined the changes in the body weight, weights of spleen and ear, thickness of dorsum skin and ear skin, clinical aspects on dorsum skin, historical assessments, proliferation of splenocytes in vitro and in vivo, and cytokine (TNF-${\alpha}$, IL-10). Results From the experiment, the ear weight of AI spread & feeding group was significantly dropped and the ear thickness of both AI spread and AI spread & feeding were decreased significantly. Dorsum skin thickness was also decreased significantly in both AI spread and AI spread & feeding group. Also, AI treatment improved the symptoms of AD, such as coloration, erythema and desquamation and had a better effect on AI spread & feeding group. In histopathological observation, thickened epidermis, hyperkeratosis, pigmentation, hypergranulosis, parakeratosis were diminished as well in both AI spread and AI spread & feeding group. In vitro, we could observe when AI was increased as proliferation rate of splenocytes were increased, too. Conclusions In conclusion, these data suggest that AI can decrease symptoms of AD and show AI can be useful herbal therapy for AD.

• Therapeutic Science for Rehabilitation
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• v.10 no.1
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• pp.37-52
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• 2021

Introduction : Oral motor function is basic function of sensory exploration, feeding, and communication, that develops from the fetal stage to childhood. Problems with oral motor function result in difficulty within handling food in the oral cavity, decreased swallowing and feeding skills, difficulty with communication, and problems with oral hygiene. To treat these symptoms, oral motor therapy is provided for normalizing sensory adaptation in the oral cavity, and increasing postural control, oral movement and oral motor function. Discussion : The oral motor facilitation technique (OMFT) was developed for increasing general and integrated oral motor function based on the following: 1) understanding orofacial muscular physiology; 2) a comprehensive approach to sensory·adaptation·behavior·cognition; 3) sensorimotor stimulation by a manual approach; 4) motor control and motor learning theory. The OMFT is a new evidence-based treatment protocol, for children and adults with neuromuscular and oral motor problems. Conclusion : The goal of this article is to provide a theoretical background for OMFT development and the basic concept for the clinical application of OMFT. We hope that this article will help oral motor therapy experts to provide effective therapy in a more professional way.